Opiates Withdrawal and Detox
Opiate detox typically signals the beginning of recovery, ultimately eliminating dangerous substances and restoring your psychological and physiological health. Using opiates – even when prescribed – involves some level of risk. There is a high risk of overdose associated with opiates. A number of unwanted side-effects – such as constipation and slow activity levels – may be responsible for your desire to quit. Quitting opiates can be challenging, with attempts to reduce or abruptly stop usage resulting in the onset of severely unpleasant withdrawal effects, which could cause you to relapse.
The ideal way to maximise comfort, minimise risks and prevent a relapse during opiate withdrawal is to undergo detox at an accredited facility. During this difficult stage, all of the toxins and substances from opiates are expunged from your body. Uncomfortable withdrawal symptoms may appear because your body is already used to opiates, and removing the substance from your system can lead to dangerous, possibly life-threatening complications.
What is Opiate Detox?
Generally, detoxification refers to the process of breaking down and removing toxins from the system. It is the first stage in substance abuse treatment and depending on the severity of your opiates dependence, may take anywhere from a day to a week to complete. If you are addicted to opiates, detox can be an uncomfortable experience, as your brain may have been rewired by the opiates to believe that it can no longer function properly without the drug. When the drug is removed from your system, volatile reactions occur, which you experience as withdrawal symptoms.
A medically assisted detox is most beneficial when detoxing from opiates. This type of detox can be provided to you via inpatient or outpatient treatment, depending on the intensity of your withdrawal symptoms, living situation and transportation availability, level of support, and any previous attempts of detox and treatment.
What is Opiate Withdrawal?
If you become dependent on opiates or ‘opiate painkillers’ -such as prescription drugs like codeine, tramadol or dilaudid) – you may feel a need to keep on using them in order to function normally. If you attempt to quit ‘cold turkey’, a range of symptoms may be experienced, as your body tries to adjust without the substance. This is known as opiate withdrawal, and it occurs when you suddenly stop using the drug or significantly reduce the amount you’re used to.
Even though symptoms during opiate withdrawal may not be life-threatening, they can still result in severe physical and mental distress for you. In many cases, because of the intensity of symptoms, trying to end your drug usage on your own may lead to a relapse. However, continuously stopping and resuming opiate usage will only make it harder to quit later on. This is because the cycle of quitting and relapsing can result in addiction.
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Contributing Factors to Withdrawal
The major contributing factor to withdrawal is a discontinuation or reduction in the use of opiate drugs. Opiates lead to physical dependence, which means that if you stop using or drastically reduce your intake, you may experience severe opiate withdrawal symptoms. You may have become so addicted to the substance that it is almost impossible to stop. Therefore, you’ll keep on consuming the opiates to prevent withdrawal. In addition, after a period of usage, you may require a greater amount of the drug to produce the required effects.
When you stop taking opiates, your body needs some adjustment period. As a result, you’ll experience opiate withdrawal symptoms. These occur particularly when you’ve been using opiates heavily for a prolonged period of time. If you become physically sick after stopping opioid medication, it could indicate that a physical dependence on the drug has developed. The withdrawal symptoms you may experience are your body’s physical response to the absence of the drug.
How Opiates Affect the Brain and Body
When ingested, opiates self-attach to the opioid receptors in your brain, spinal cord and gastrointestinal tract, exerting their effects on those organs. The brain naturally manufactures its own opioids, which are responsible for calming your body down, managing the pleasure and reward systems in the brain and even helping to prevent depression and anxiety. However, when you take man-made opiates, your brain gets an extreme rush of dopamine – an important neurotransmitter – resulting in an extremely high level of pleasure or excitement.
Opiates affect your brain and body in different ways:
- Opioids may affect the brainstem (which controls functions like breathing and heartbeat) by slowing breathing or reducing coughing.
- Opioids may act on specific areas of the brain, known as the limbic system, which control emotions to create feelings of pleasure or relaxation.
- Opioids work to reduce pain by affecting the spinal cord, which sends messages from the brain to the rest of the body, and vice versa.
Why You Should Detox Properly from Opiates
Detoxing properly from opiates is an essential and foundational step to ensuring you begin an effective journey into recovery. If you’re suffering from opiate dependence or addiction, making the important decision to go to a drug rehab centre is the first step towards freedom. Drug rehab centres are important in helping you overcome your opiate addiction and be free of the feeling of being emotionally, physically and mentally dependent on a drug to cope with life. Opiates detoxification must occur before you can learn to manage everyday life without the urge to use drugs.
Before therapists can help you secure a sober life and develop effective coping mechanisms, you need to undergo proper detoxing from opiates prior to any treatment. Detoxification will ensure you are completely sober before starting a comprehensive treatment programme. Detoxification will help you become sober and learn to deal with the symptoms associated with the absence of opiates.
Causes of Opiate Withdrawal
The main causes of opiate withdrawal are a combined result of prescribed usage of opiates such as prescription painkillers and the use of these drugs for recreational purposes. When you use opiates successively or repeatedly for a long period, your body will naturally develop a tolerance to the drug. This means that you will require more and more in order to obtain the desired effects. As your tolerance increases, you may turn to abusing the drug by taking even greater doses in order to feel less pain or to achieve the full effects from the drug.
After physical dependence has set in, and you abruptly stop taking opiates or dramatically reduce your regular dosage after prolonged use, your body reacts by sending signals that more opiates are needed in order to function. These signals are called ‘withdrawal symptoms’ and they may be mild, moderate or severe, depending on your level of opiate abuse, type of drug being used and the length of time you’ve been using.
How Opiate Withdrawal is Diagnosed
A physical examination will be performed by your primary care provider in order to diagnose opioid withdrawal. Urine and blood tests may be required as well to check your system for the presence of opioids. After the exam, you will also be asked questions about your symptoms. Questions may also focus on your past drug usage and medical history. To get the best treatment and support, it is essential to answer the questions as openly and honestly as possible.
In addition, there are some criteria that must be present before a diagnosis of opiate withdrawal can be made. They include:
- More opioids are taken than intended
- The individual is unable to decrease the amount of opioids used
- Large amounts of time spent trying to obtain / use opioids or recover from taking them
- The individual has cravings for opioids
- Difficulty fulfilling professional duties at work or school
- Continued use of opioids leading to social and interpersonal consequences
- Decreased social or recreational activities
- Using opioids despite physically dangerous settings
- Continued usage, despite opioids worsening physical or psychological health (i.e. depression or constipation)
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Common Opiates: Detox and Withdrawal Symptoms
Withdrawal from opiates is often painful and uncomfortable. The length of time it lasts and the severity of symptoms during your detox and withdrawal stage depends on the exact opiate you’ve used, as well as how long and how much you’ve been using. Withdrawal includes both physical and mental symptoms. When you are unable to obtain more of the drug, or undergoing a detox, the symptoms you experience may increase in severity. They commonly begin after your first day without the drug and last for up to a week before subsiding.
The detox and withdrawal symptoms range from mild to intense. They are most severe when you are suffering from an extensive drug abuse or addiction. This means you have been consuming large doses of opiates over a significant period of time. Other factors that may influence the type of withdrawal symptoms you experience include your current state of health and any co-occurring mental disorders. Within 24 hours of your last dose, you may begin to experience a combination of the most common symptoms of opiate withdrawal and detox, including: anxiety, diarrhoea, stomach aches, runny nose, sweating and so on.
Physical and Psychological Symptoms of Opiates Withdrawal and Detox
Detox and withdrawal are often regarded as the toughest parts of recovering from opiate addiction. As a result of the inherent challenges, coupled with the undesirable effects of the process, it is essential to make the process as comfortable as possible to ensure your safety as you begin your recovery journey. After you start detox or cut down on the amount of opiates you’re taking, a number of physical and psychological symptoms may begin to appear. This is called ‘withdrawal’.
The initial symptoms of withdrawal can begin to occur within the first day of your detox. These physical and psychological symptoms of opiate withdrawal and detox include: restlessness, uncontrollable yawning, anxiety, muscle aches and spasms, insomnia, runny nose, irritability, excessive tearing and sweating, aggression, mood swings, depression, and an inability to concentrate. After these initial symptoms subside, you may begin to experience more severe and longer lasting symptoms, such as:
- Rapid heartbeat
- High blood pressure
- Dilated pupils
- Abdominal cramping
While these symptoms make up an extremely difficult and intense phase of opiate withdrawal and detox, they subside with time as your body starts to adjust to functioning without drugs.
How Long Does it Take to Detox from Opiates?
Detoxing from opiates is one of the most difficult drug addiction detoxes to undergo. Most opiates are highly addictive and can result in some severe changes to the pleasure mechanisms in your brain, which are difficult to reverse. Therefore, when considering how long it takes to detox from opiates, it is important to remember that your experience will be significantly different from that of another person. For some, withdrawal symptoms may last longer than five days, while for others, they will give way after a week.
Depending on the severity of your dependence or addiction, a physical detox takes about two to three weeks, while a mental detox may last much longer in cases of prolonged opiate abuse. Both physical and mental symptoms (as well as cravings for opiates) can return for weeks or months after quitting. However long it takes to detox, you can make this challenging period more bearable by focusing on your goal of recovery and making use of tools like exercise and healthy eating.
Opiate Withdrawal: Timeline of Symptoms
Knowing what to expect during opiate withdrawal is one of the best ways to prepare for the process. The timeline of symptoms varies from one person to the next, depending on a range of factors, including the extent of abuse. With most withdrawals however, you can expect timelines to follow a similar course.
Phase 1: Days 1 – 3
Many withdrawal symptoms begin within the first 24 hours after you stop using opiates. These symptoms can be highly uncomfortable, while some might even be painful. Always keep in mind that discomfort is only temporary. As a result of the difficult symptoms, there is a high chance of a relapse in the first few days of withdrawal. Symptoms of the initial phase of withdrawal include:
- Panic attacks
- Stomach problems
- Muscle pain
- Loss of appetite
Phase 2: Days 3 – 5
Most of the intense symptoms you experienced during the first phase of withdrawal will usually have subsided by the second phase. At this point, you are more likely to feel:
- Stomach cramping
- Minor muscle aches
What is Acute Opiate Withdrawal?
Acute opiate withdrawal is the first phase during the withdrawal period. It usually begins about 12 hours after the last time you used the drug. The acute stage peaks between three to five days and may last for approximately one to four weeks. Generally, opioid withdrawal symptoms can last anywhere from one week to a month. At the acute stage, your symptoms are mainly physical, while by the second stage, post-acute opiate withdrawal features more psychological and emotional symptoms. The symptoms of post-acute withdrawal are not as severe. However, they last longer, and in some cases can run into years.
Acute opiate withdrawal symptoms include:
- Abdominal cramping
- Low energy, Irritability, Anxiety, Agitation
- Yawning, Insomnia
- Runny nose, Teary eyes
- Hot and cold sweats, Goose bumps
- Muscle aches and pains
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Coping with Opiate Withdrawal
Sometimes, the thought of opiate withdrawal can seem scary and overwhelming, but the reality is that you can get through it and enjoy a drug-free life thereafter. Although it is crucial to let the withdrawal stage run its course, there are some effective ways to cope. Having a support system throughout the withdrawal process is important. This can include your friends, family and even medical help. During withdrawal, you may experience moments where it seems too difficult and you want to quit. It’s best to have someone near you for support and mental strength.
In addition, you can join a group like Narcotics Anonymous to get some support during withdrawal. Such groups also create the chance for you to find a sponsor, who can help you as you begin your recovery process. Taking good care of yourself is another way to cope with opiate withdrawal. This includes drinking plenty of fluids, eating foods like bananas, yogurt and saltines that sit well in the stomach, meditating and getting a lot of rest.
During opiate withdrawal, diarrhoea (which is a common symptom of withdrawal) can result in possible complications. Loss of fluids and electrolytes can result in abnormal beating of the heart, circulatory problems and even heart attack. To avoid such complications, it’s important to drink plenty of water to replace any fluids you’ve lost. Nausea and vomiting are other common symptoms during the withdrawal stage. Serious complications can occur from inadvertently ingesting vomit into your lungs, which can cause aspiration pneumonia to occur.
Another very common complication which may arise during opiate withdrawal is that you may decide to return to your previous state of drug use. In many cases, the withdrawal symptoms may become so severe that you begin to think that the only way to survive is to resort back to using drugs. Unfortunately, if you have recently passed through detox and experienced withdrawal symptoms, your tolerance becomes reduced. This puts you at greater risk of overdosing on opiates during this crucial period.
How We Treat Opiates withdrawal
Opiates withdrawal can be a painful process. If you’re suffering from long-term opiate addiction, we ensure detox is carried out in a controlled environment and under the care of medical professionals. In a case of mild opiate withdrawal symptoms, we provide treatment with aspirin, acetaminophen (or Tylenol), and nonsteroidal anti-inflammatory drugs like ibuprofen. More advanced opiate withdrawal is treated with clonidine to handle symptoms such as anxiety, cramping, muscle aches and restlessness.
To prevent constipation, suboxone – which is made up of an opiate blocker (naloxone) and a milder opiate (buprenorphine) – is used. Suboxone is also effective at shortening the length of detoxification if orally administered. Methadone can also be used during detox (and afterwards) as a medication for long-term maintenance. Since this strong opiate can also lead to abuse and addiction, it is only taken under the supervision of a medical professional.
Medications to Treat Opioid Withdrawal
The medications used to treat opioid withdrawal help to treat any long-term issues you may have developed, including drug cravings. With time, your doctor will slowly taper down your dosage until you are fully recovered from acute withdrawal symptoms. Some of the common medications used to treat opioid withdrawal include:
This medication is often prescribed to contain withdrawal symptoms and treat high blood pressure. It can be given as an oral tablet or as a patch that you can wear on your skin. As an opioid medication, clonidine has little potential for abuse and addiction, because it does not produce euphoric effects. It can therefore be easily discontinued after your withdrawal symptoms subside.
This is used to help you ease off the drug you have developed dependence for. It is a long-acting opioid, and a very effective method to use if you are struggling with long-term opiate addiction.
Although Buprenorphine is commonly used in treating alcoholism, it is also very effective for treating opiate withdrawal. This medication is a partial agonist, and therefore doesn’t mimic the total effects of heavy opiates like Hydrocone. It controls the symptoms of withdrawal, so that you can stay motivated during treatment.
Melatonin Remedies for Natural Opiate Withdrawal Symptoms
Opiate dependence and addiction can deplete the natural melatonin levels in your brain and body. This can lead to opioid withdrawal symptoms, such as poor moods and insomnia. Melatonin can be highly beneficial during withdrawal from opiates like heroin, hydrocodone, oxycodone, oxycontin and so on. Using melatonin for opiate withdrawal symptoms has been found to boost immune function, reduce the occurrence of headaches and help your body heal by allowing sleep. You can offset many of the negative side effects of withdrawal by taking a melatonin supplement.
More benefits of using melatonin as a natural remedy include the prevention of oxidative damage to your brain cells, as this is what causes headaches, erratic sleeping habits and other withdrawal symptoms. The appropriate dosage of melatonin depends on your own needs. It is always best to start small and see if you need to increase your dosage.
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Moving from Opiates Detox to Rehab
A successful recovery cannot be achieved through detoxing alone. If you complete detoxification without undergoing a drug rehabilitation programme afterwards, you face an increased risk of relapse. After your detox is completed, the second (longer) phase of treatment begins, which is where you can achieve the behavioural changes you’ll need in the future. Opiate treatment rehabs offer a wide range of support and therapy, with the aim of helping you discover and understand the root issues leading to your addictive behaviour and then teach you better ways to respond to them.
Most opiate inpatient treatment programmes offer individual, group and family therapy, 12-step or non-12 step meetings and counsellors that provide encouragement and lessons about techniques you can employ to stay clean and sober. Opiate addiction can be challenging to conquer, and you are going to need a significant amount of help in order to be successful. A professional rehab programme can provide that help, including holistic therapies like meditation, yoga, acupuncture and music therapy to help you achieve self-discovery and recovery.
Medical Detox as Part of a Whole Treatment Plan
Medical detox is performed under the care of a physician to help you withdraw safely from addictive drugs. Using opiates and other drugs for a prolonged period can lead to physical dependence and stopping them can result in withdrawal symptoms. The process of detoxification is aimed at treating the immediate physical effects of abruptly stopping opiate usage and eliminating the toxins left in your body as a result of the chemicals found in the drugs ingested.
When dealing with opiate abuse and addiction, medical detox can make your treatment plan even more effective. It is therefore preferable to undergo medically supervised detoxification in a residential treatment centre with a detox unit in order to safely withdraw. This is the case particularly if you’ve been heavily using opiates for a long period of time, as there is a bigger chance of severe symptoms. Generally, medical detox involves the administration of a similar agent to your drug of abuse in a tapering manner – gradually decreasing doses to prevent withdrawal. With medical opiate detoxification, methadone is the most common medication used and you’ll typically be tapered down from your usual dose to zero within 21 days.
Opiate Detoxification Timeline
Generally, the duration of opiate detox depends on your level of dependence. Without any medical supervision, it can last anywhere from a few days to a week or more, as your body gets rid of the substance, and you start to experience withdrawal symptoms. During detoxification, withdrawal symptoms tend to build upon one another, with the first set giving way to the next, and so on. Early into your detox, the first symptoms that surface include bad mood, shaking and nausea. Afterwards, vomiting and diarrhoea may occur, increasing in intensity until your symptoms peak and begin to taper off in the detox process.
Some questions to ask when trying to estimate your detoxification timeline include: did you use the opiates with other drugs? Was this your first usage or do you have a history of prolonged abuse? Answers to these questions will determine how long it might take you to go through your detox. For example, if you’ve struggled with addiction for many years, your detox might take longer than that of a younger person who has only been using for a few weeks.
Finding the Right Treatment
This is the best time to begin your opioid addiction treatment, and a medically assisted withdrawal is one of the most effective ways to start. The key thing is to ensure your treatment is carried out under medical supervision, and that any medication you take during this period is exactly as prescribed by your doctor. Medical detoxification is simply the first stage and cannot help you quit long-term opiate use.
This is why a lot of rehab centres offer a range of therapy options during withdrawal to help you transition smoothly into addiction rehab. Therefore, this is a necessary first step if you are entering treatment as a result of dependency through recreational opiate usage or from using without adhering to your prescription. Seeking treatment is always important when detoxing, and the right treatment will allow you to get the appropriate help for your recovery.
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How Safe is Home Detox for Opiate Abusers?
It’s extremely risky to try to taper off your use of opiates without help from a doctor, especially when you are unsure what steps to take. In addition, consuming opiate medications without a doctor’s prescription is both illegal and dangerous. Trying to detox from opiate usage at home puts you in a very precarious position. The safest thing to do is to seek the help of a licensed medical professional for treatment. Whether you want to go ‘cold turkey’ or slowly taper off, doing so at home without a professional’s help is more likely to end in relapse.
Instead, professional detox treatment is how you can avoid this and the other dangerous side effects of relapsing. Even if you make it through a home detox without relapsing, you should still seek professional addiction treatment. This is important, because without actually receiving the help you need, you are putting yourself at huge risk of relapse.
Self-Detoxification from Opiates
If you decide to go through with self-detoxification, you’ll need to be prepared. Try to gradually taper off the opiates instead of quitting them abruptly, so that the intensity of your withdrawal symptoms is limited. However, you might find self-regulated tapering to be impossible because of the compulsive nature of addiction, as well as the strong reactions that might result. It often causes a full relapse into addiction.
Preparation is key in self-detoxification. Your withdrawal symptoms may last from days to weeks. Using the recommended doses of over-the-counter medications can be helpful, such as Loperamide (Imodium) for diarrhoea, Meclizine (Antivert or Bonine) or Dimenhydrinate (Dramine) for nausea. With a couple weeks’ worth of medication, you can avoid the need to leave your home to purchase more. However, you should be careful not to use more than the correct dosage. If you’re not experiencing the desired effects from the regular dose, discuss the issue with your doctor.
Medically-Assisted Therapy for Opiate Dependency
Opiate dependency and the recovery process are typically marked by the strong urge to use, even after you have successfully completed detox and treatment. This urge is normal, even as you struggle to stay clean, and can increase the risk of relapse. Fortunately, these urges and cravings for opiates can be successfully staved off with the use of certain medications.
Combining these medications with therapies that guide you with regards how to deal with your cravings and triggers can help extend your sobriety. There are a number of different medications that can be prescribed to treat opiate dependency, including methadone, naloxone, buprenorphine, naltrexone, acamprosate and disulfiram.
After Detox: Staying Off Opiates
Addictions cannot be ‘cured’ through detox. When completing a detox programme, you’ll need to stay away from the people and places you used to associate with when using opiates. By avoiding your drug-using associates and old stomping grounds, you can change your previous habits and develop new and healthier ones. Also, cravings and the temptation to go back to drugs in the early stages of your recovery will be easier to deal with.
The reward centres in your brain become affected when you are addicted to drugs, leading to physical and emotional dependency as a result of the changes that have occurred in your motivational pathways. With opiate detox, you can achieve physical stabilisation, but finding a healthy psychological balance is equally as important. One of the best things you can do to ensure you stay off opiates after detox is to get into a treatment programme, where you can benefit from individual and group therapy.
Opiate Addiction: Facts
- Addiction to an opiate, commonly referred to as a narcotic, is a major health and social problem in the world today
- It’s possible to develop a psychological dependence on opiates, where one believes they must use in order to feel normal
- Opiate addiction develops quickly over time and is characterised by an inability to stop using
- Opiate addiction is a brain disease
- Opiate addiction is not curable, but can be managed through treatment and recovery programmes
- Fear of severe and uncomfortable withdrawal symptoms such as nausea and vomiting, restlessness, muscle and bone pain, prevents opiate addicts from seeking treatment
- Opiates can lead to respiratory failure, high blood pressure and cardiac arrest
- Whilst in recovery, opiate addicts will often relapse and may have to go into treatment several times to achieve success
How do you know if you’re suffering from opiate withdrawal?
You can tell you’re suffering from withdrawal when you know the opiates you’re abusing are bad for you – and cause you to suffer physical, mental and emotional effects – but you keep on using them.
Is Opiate Withdrawal Dangerous?
Opiate withdrawal is especially dangerous without professional treatment, as you could be at risk of developing serious complications.
How Long Does Opiate Withdrawal Last?
Withdrawal symptoms can last anywhere from a couple of days up to a week or longer. In rarer cases, opiate withdrawal can last for months. It takes time for the body to fully rid itself of drugs and begin to heal.
How Does Opiate Withdrawal Affect My Health?
During opiate withdrawal, your body cannot get the nutrients it needs to help restore strength and subsequently heal.
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